Endotracheal intubation is a high-risk and high-consequence medical procedure which involves the placement of a flexible plastic tube into the trachea of a patient to protect the airway while providing mechanical ventilation. The procedure is performed by a wide range of health care providers in cases of emergency respiratory arrest and many surgeries. Since 1987, more than one million malpractice suits were settled related to difficult airway management. The cost to health care providers of litigation, additional procedures required as a result of complications and the cost of airway management training are staggering. Complications surrounding airway management and endotracheal intubation require new and innovative educational techniques to better train health care providers on proper techniques and decrease the cost to health care providers.
A major provider of intubation simulation devices used in training is Laerdal Medical Corporation of Wappingers Falls, N.Y. Laerdal has pioneered several upper-respiratory intubation trainers such as VitalSim® and SimMan® for use by health care providers ranging from nursing students to board certified clinicians. SimMan® is presently their most sophisticated and advanced training device. SimMan® is a portable and advanced patient simulator for team training that has realistic anatomy and clinical functionality that allows students to practice emergency treatment of patients through simulation-based education that is designed to challenge and test students' clinical and decision-making skills during realistic patient care scenarios. SimMan® is representative of a patient simulator capable of providing feedback of the care administered specific to the medical condition.
A basic but significant limitation of training medical procedures on real patients or such patient simulators is that bodies are (mostly) opaque. For many procedures (e.g., without limitation, endotracheal tube insertion, Foley catheter placement, bronchoscopy, central line placement) it would be advantageous if patients were “see through” so that a trainee could see what was actually occurring within the body as the trainee manipulated a tool or device. Presently, systems exist that project simulations of internal structures onto a body, however such systems do not allow for interaction by a trainee and do not provide any type of feedback as to foreign structures, such as medical instruments, placed into a body. An example of such a system is the Virtual Anatomical Model developed in the Virtual Systems Laboratory of Gifu University, in the city of Gifu, Gifu Prefecture, Japan. Such system projects computer generated images of anatomy onto a rigid white body form. The position and orientation of the form is tracked and the images are transformed appropriately so that it appears to users that they can rotate the body and see the internal anatomy from different orientations. Such system, while offering potential utility for the study of anatomy, does not provide for procedural simulation, i.e., it does not track the position of medical devices and display their internal representations in accurate relationship to internal structures, does not display displacements or other positional alterations of internal structures as they are contacted by medical devices and does not allow interaction with medical devices to be viewed internally. Such system also requires that the images be viewed through a small hand-held window frame which is tracked in order to correct for parallax errors. The use of such viewer window does not lend itself to group learning environments as accurate viewing is limited to a single person at a time.
As such, there exists a need for improved systems and methods for teaching medical procedures including, without limitation, those procedures that involve the external manipulation of a medical device that is moving or acting inside the body. There may be significant advantages to a system that during training enables the visualization of the internal portions of tools and devices and the relevant anatomy with which the tools interact. Such real-time, interactive visualizations may permit trainees to develop better mental models of the internal consequences of their external actions. These mental models may in turn help trainees to acquire skills more quickly and efficiently, achieve higher levels of proficiency, and help them more effectively to identify and avoid potential errors that could cause harm in an actual patient.